| NPI | 1033196605 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MS 16878) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MS 16878) |
| Enumeration Date | 2005-12-27 |
| Last Update Date | 2019-06-19 |